A previously healthy 17-year-old in Japan developed pain in his lower belly after a cold left him with a severe cough. He had no injury, took no blood thinners, and had no bleeding disorder. His abdomen looked completely normal, with no bruise, lump, or swelling. Imaging eventually explained the pain: blood had collected inside the tough sheath that wraps one of his abdominal muscles.
The case, published October 14 in the Journal of Surgical Case Reports, comes from doctors at Jyoban Hospital of Tokiwa Foundation in Iwaki, Fukushima. They describe a cough-induced rectus sheath hematoma. In their review of recent cough-related cases, he was the youngest patient and the only one with neither a known risk factor nor a visible sign on the abdomen.
